Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04846 | Date 23/04/2019 |
| Token No | SM/19-20/3100 21/05/2019 | Serial | 048 Last Visit: 15/06/2019 |
| Patient Name | Mrs. MOUSUMI GHOSH | Contact No | 9231889260 |
| Address | 3A CHTARA DHARMOTALA BYE LANE SERAMPORE | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||